Arleisha Strauder
Las Vegas
Summary
Pharmacist with a strong record of improving medication access and patient outcomes in fast-paced environments. Skilled in reviewing prior authorization requests, ensuring regulatory compliance, and collaborating with healthcare providers to facilitate timely treatment while maintaining high-quality standards.
Overview
19
19
years of professional experience
Work History
Prior Authorization Pharmacist
UHG/Optum Rx
Las Vegas
09.2025 - 02.2026
- Reviewed Medicare prior authorization requests and rendered coverage determinations based on clinical criteria, evidence-based guidelines, and plan design
- Monitored prior authorization criteria and guidelines set by insurance companies.
- Processed prior authorization requests using web-based systems and faxed submissions.
- Provided timely responses to requests for prior authorizations.
- Gathered, analyzed, and documented clinical information and coverage policies to ensure compliance with CMS requirements and regulatory guidelines.
- Maintained established productivity standards and quality performance targets, ensuring compliance with state and federal pharmacy laws and regulations
- Collaborated with physicians and healthcare providers to address clinical and administrative questions related to prior authorization requests
- Engaged with healthcare providers to obtain clarification on prescription details.
- Supported fellow pharmacists by addressing inquiries about processing prior authorization requests.
- Developed and implemented strategies to enhance workflow efficiency while maintaining compliance with regulatory requirements.
- Analyzed data from claim systems and electronic medical records to streamline information gathering for processing prior authorization requests.
- Advised physicians on appropriate use of medication therapies based on clinical evidence and cost effectiveness.
- Built and maintained productive working relationships with cross-functional colleagues and management to support workflow efficiency and quality outcomes
- Communicated effectively with leadership regarding workplace safety concerns and equipment needs to support operational continuity
- Ensured strict adherence to pharmacy laws, regulations, and standards, including controlled substances management.
Staff Pharmacist
Costco Wholesale Corporation
Henderson
07.2016 - 03.2020
- Reviewed prescription orders for accuracy and appropriateness, applying clinical judgment and drug utilization guidelines across diverse patient populations
- Identified potential drug interactions, contraindications, and duplicate therapies using clinical decision-making tools and pharmacy systems
- Collaborated with physicians, nurses, and insurance providers to address medication-related issues, facilitating timely access to necessary therapies
- Educated patients on complex medication regimens, enhancing understanding and adherence through effective communication and advocacy
- Streamlined high-volume workflow while ensuring accuracy, meeting deadlines, and maintaining regulatory compliance (HIPAA, FDA, Board of Pharmacy)
- Adapted quickly to evolving payer policies and pharmacy benefit changes, ensuring timely medication access for patients
- Applied strong organizational skills to track clinical issues, resolve medication access barriers, and follow up on unresolved insurance concerns
- Maintained consistent quality metrics and customer satisfaction scores in a fast-paced, performance-driven environment
- Trained and supervised pharmacy technicians in processing prescriptions and handling insurance-related workflows, enhancing team efficiency
- Conducted regular audits of sensitive documents to ensure compliance with healthcare regulations and maintain data integrity.
Pharmacy Manager
Costco Wholesale Corporation
Henderson
05.2007 - 07.2016
- Led daily pharmacy operations in a high-volume setting, overseeing clinical services, workflow optimization, and team performance to ensure timely and accurate prescription fulfillment, ensuring compliance with laws and policies, and contributing to operational excellence.
- Spearheaded initiatives that enhanced medication access and reduced dispensing errors through targeted team training and workflow redesign
- Applied evidence-based clinical judgment to resolve medication access issues, including prior authorization denials, therapeutic alternatives, and insurance formulary compliance.
- Collaborated with prescribers and insurance providers to expedite prior authorizations, clarify prescriptions, and ensure medication appropriateness across diverse therapeutic areas.
- Trained and supervised pharmacists and pharmacy technicians on insurance processing and claim troubleshooting, ensuring compliance with third-party payer policies
- Ensured regulatory compliance with HIPAA, state board requirements, and company protocols, safeguarding patient privacy and pharmacy integrity
- Delivered patient-centered education on drug therapies, managing complex clinical conversations with clarity and professionalism
- Consistently met or exceeded key performance indicators (KPIs), including prescription accuracy, turnaround time, and patient satisfaction scores
Education
Doctor of Pharmacy -
Roseman University of Health Sciences
Las Vegas06-2004
Bachelor of Arts - Chemistry
University of Nevada-Las Vegas
Las Vegas, NV08-2000
Skills
- Authorization processing
- Benefit management
- Claim verification
- Pharmacy Operations
- Clinical and Technical Knowledge
- Clinical decision-making
- Clinical Problem Solving
- Medication Utilization Review
- Clinical judgment
- Clinical Guidelines Application
- Quality Assurance
- Compliance Awareness
- Regulatory Standards Adherence
- Risk Assessment
- Pharmacy Management Systems
- HIPAA
- Accurate Record Keeping
- Patient Care Documentation
- Software proficiency
- Time management
- Interdepartmental Communication
- Communication Skills
Timeline
Prior Authorization Pharmacist
UHG/Optum Rx
09.2025 - 02.2026
Staff Pharmacist
Costco Wholesale Corporation
07.2016 - 03.2020
Pharmacy Manager
Costco Wholesale Corporation
05.2007 - 07.2016
Doctor of Pharmacy -
Roseman University of Health Sciences
Bachelor of Arts - Chemistry
University of Nevada-Las Vegas